Professional Healthcare Consulting
- HEALTHCARE ACCREDITATION/PREPARATION:
- URAC
- NCQA – National Committee Quality Assurance
- AAAHC Accreditation Association for Ambulatory Healthcare
- The Joint Commission (TJC)
- COMPLIANCE:
- Compliance Program
- Compliance Officer
- Compliance Audits
- Compliance Committee Meetings
- CREDENTIALING:
- Primary Source Verification of Credentials
- Monthly sanctions, violation Checks various organizations
- Re-Credentialing, Quality monitoring
- Credentialing Committee Meetings
- HEDIS:
- HEDIS - Healthcare Effectiveness Data Information Set
- HEDIS – Training in relation to NCQA
- Informatics
- QUALITY MANAGEMENT:
- Quality Management Program
- Quality Management Committee Meetings
- Quality Management Indicators
- Quality Management Work Program
- Quality Improvement Project (QIP)
- RISK MANAGEMENT:
- Risk Management Program
- Licensed Healthcare Risk Manager
- AUDITS/POLICIES/PROCEDURES:
- Any departmental needs
- Regulatory
- Mock Survey Audits
- STARS PROGRAM:
- HEDIS
- CAHPS/ HOS
- CMS/ IRE
- UTILIZATION MANAGEMENT:
- Benefits management
- Cost containment: Appropriateness of care
- Evidence based criteria/clinical guidelines
